Insurance Eligibility and SFS Coordinator

Hope Christian Health Center•North Las Vegas, NV

About The Position

The Insurance Eligibility and SFS Coordinator participates in the delivery of excellent medical services in a patient-centered medical home environment with an emphasis on the prevention of disease. By thoroughly verifying patient insurance eligibility, determining Sliding Fee Scale eligibility and maintaining accurate patient demographic and insurance information to support timely access to care and accurate reimbursement. This position ensures compliance with payer requirements, ensures accurate data entry and maintains the confidentiality of patient information while providing excellent and affordable healthcare.

Requirements

At least 1 (one) year of insurance verification in a medical clinic or facility - Required
Fluency in English - Required
Fluency in Spanish - Required
High School Diploma or equivalent - Required
Knowledge of CPT and ICD-10-CM coding
Ability to operate general office machinery (computers, calculators, copy/fax machine, telephones, etc.)
Ability to interact with people from all ethnic backgrounds, ages, and lifestyles; ability to understand and respond appropriately, effectively, and sensitively to special populations

Nice To Haves

Faith to believe that Hope is a ministry of God, exemplifying the love of Christ, and held and directed by the Holy Spirit.
Outstanding ability to build interpersonal relationships at all levels.
Excellent communication skills, both written and verbal.
Demonstrated passion for community health care.
Proven leadership, teambuilding, and organizational skills.
Proven ability to maintain integrity in a fast paced and high-demand environment.
Proven ability to manage performance goals.

Responsibilities

Verify patient identity, medical insurance, and establish if patient is eligible for Sliding Fee Scale to ensure accurate completion of each visit.
Remind patients of upcoming appointments, follow-up visits, and referrals as applicable.
Update the Electronic Medical Record (EMR) with accurate insurance information, demographic changes, primary care provider (PCP), co-pays, and coverage details.
Correct insurance entry errors that impact patient eligibility, laboratory billing, claims processing, and reimbursement.
Ensure patient insurance coverage and eligibility accuracy to prevent claim denials.
Provide accurate and detailed phone messages to other team members.
Obtain patient consent/signature(s) when necessary.
Review and reconcile Quest Diagnostics and LabCorp invoices for accuracy and completeness.
Investigate and dispute Quest Diagnostics and LabCorp billing discrepancies, including duplicate charges, incorrect patient information, insurance billing errors, and coding issues.
Research and correct insurance eligibility, payer information, and demographic errors in the EMR to ensure accurate billing.
Maintain a safe, secure, and healthy work environment by establishing and following standards and procedures; comply with legal regulations.
Ensure front office and clinic policies and procedures (as applicable) are always followed.
Update job knowledge by participating in educational opportunities; reading professional publications.
Attend and actively participate in staff meetings.
Develop and maintain a tracking and dating system for SFS applications, and the number of patients applying for Medicaid.
In conjunction with the accounting department, monitor and resolve financial discrepancies.
Uphold and comply with HIPAA and protect patient information.
Ensure compliance with all 19 Health Resources and Services Administration (HRSA) Health Center Program Requirements.
Actively participate in and support quality improvement activities and the clinical practice team efforts emphasizing the importance of the individual patient and putting the patient’s needs first.